Background: Hepatocellular carcinoma (HCC) is the fifth most common fatal cancer and an important healthcare problem worldwide.There are many studies describing the prognostic and predictive effects of epidermal growth factor receptor 2 (c-erb-B2) and epidermal growth factor receptor 1 (EGFR), transmembrane tyrosine kinases that influence cell growth and proliferation in many tumors.Objectives: The current study aimed to investigate the expression levels of c-erb-B2, EGFR, PTEN, mTOR, PI3K, p27, and ERCC1 in hepatocellular carcinoma (HCC) and their correlation with other clinicopathologic features.Patients and Methods: Fifty HCC cases were stained immunohistochemically with these markers.Correlations between the markers and clinicopathologic characteristics and survival rates were analyzed.Results: No membranous c-erb-B2 staining was seen, whereas cytoplasmic positivity was present in 92% of HCC samples, membranous EGFR was observed in 40%, PI3K was found in all samples, and mTOR was seen in 30%, whereas reduced or absent PTEN expression was observed in 56% of samples and loss of p27 was seen in 92% of the cases.c-erb-B2 and mTOR overexpression, as well as reduced expression of p27, all correlated with multiple tumors (P = 0.041, P < 0.001, and P < 0.001, respectively).P27 loss, and mTOR and EGFR positivity were significantly correlated with AFP (P = 0.047, P = 0.004, and P = 0.008, respectively).Angiolymphatic invasion was more commonly seen in EGFR-and ERCC1positive cases (P = 0.003 and P = 0.005).EGFR was also correlated with histological grade (P = 0.039).No significant correlations were found among PTEN , PI3K, and the clinicopathological parameters.Disease-free or overall survival rates showed significant differences among therapy modalities, AFP levels, angiolymphatic or lymph node invasions, and ERCC1 and p27 expression levels (P < 0.05).Conclusions: c-erb-B2, EGFR, mTOR, ERCC1 overexpression levels, and loss of p27 may play roles in hepatocarcinogenesis and may be significant predictors of aggressive tumor behavior.These markers were found to be correlated with certain clinicopathologic features, therapy modalities, and survival rates in the current study.These findings may help in planning new, targeted treatment strategies .
FH is an autosomal dominant genetic disorder characterized by increased TC and LDL level, which leads to xanthomas, atherosclerosis, and cardiac complications even in childhood. The treatment options are diet, medical treatment, lipid apheresis, and LT. The aim of our study was to analyze our data of patients with FH. Between 2004 and 2015, there were 51 patients who underwent pediatric LT at our center. All patients with FH were identified, and the data were retrospectively analyzed. There were eight patients with homozygous FH in the median age of 10 years (IQR 6-12) who underwent LT. The median pre-operative TC and LDL levels were 611 mg/dL (IQR: 460-844) and 574 mg/dL (IQR: 398-728) and decreased to normal levels 1 week after LT (TC: 193 mg/dL and LDL: 141 mg/dL). Two patients died two and 18 months after LT due to sudden cardiac arrest. Both patients were diagnosed with cardiovascular disease pre-operatively. The LT is the only curative treatment for this disease. To achieve an excellent outcome, it should be performed before the development of cardiovascular disease, because the regression of severe cardiovascular disease after transplantation is limited.
GIRIS Ilk defa 1963 yilinda Starzl tarafindan kadavra vericiden gerceklestirilen karaciger nakli daha sonraki yillarda hizla tum dunyada uygulanmaya baslamis olup, canli vericili karaciger nakli 1989 yilinda ilk kez eriskinden cocuk hastaya yapilmistir. 1993 yilinda yapilan eriskinden eriskine sol lob karaciger naklini, 1996 yilinda baslanan sag lob karaciger nakli izlemistir. Ulkemizde kadavradan karaciger naklinin ilk kez 1988 yilinda Haberal ve arkadaslari tarafindan gerceklestirilmesini takiben, 1990 yilinda yine ayni ekip ilk canli vericiden pediatrik karaciger naklini ve hemen ardindan ilk canli vericiden eriskin sol lob karaciger naklini gerceklestirmistir (1). Son 10 yilda endikasyon yonunden de buyuk ilerlemeler olmus olup hepatoselluler karsinoma (HCC), noroendokrin tumorler, Budd-Chiari hastaligi, alveoler hidatik kist gibi bircok hastaligin tedavisinde karaciger nakli yaygin olarak uygulanir hale gelmistir.
BACKGROUND AND AIMS: The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk tool and Revised Cardiac Risk Index (RCRI) are recommended tools for cardiovascular assessment before non-cardiac surgery to predict early postoperative cardiac morbidity and mortality.Their predictive value for postoperative cardiovascular morbidity and mortality after liver transplantation is unknown.We aimed to evaluate the validity of these two risk tools to predict early (30-day) cardiovascular complications and inhospital all-cause mortality.METHODS: Patients who underwent living donor liver transplantation were retrospectively analyzed.Consecutive 278 adult patients were included and their NSQIP and RCRI scores were calculated.RESULTS: Cardiovascular morbidity occurred in 5 (1.8 %) patients.In-hospital all-cause mortality occurred in 18 (6.4%) patients.None-of the patients died from cardiac complications.Causes of cardiac morbidity were as follows; acute coronary syndrome in 1 patient, intraoperative cardiac arrest with successful resuscitation in 1 patient, heart failure in 3 patients.Neither the NSQIP nor the RCRI score were associated with cardiovascular morbidity.Only RCRI medium-high score, DM and Nonalcoholic steatohepatitis as transplant indications were associated with in-hospital all-cause mortality (p = 0.001).CONCLUSIONS: The NSQIP risk calculator and RCRI scores failed to accurately predict the risk of perioperative cardiac complications (Tab.3, Ref. 30).
BACKROUND: The aim of this study is to identify the preoperative variables associated with prediction of intraoperative blood transfusion as well as analyze the influence of intraoperative blood transfusion on postoperative outcomes. MATERIALS and METHOD: Between June 2004 and May 2006 a total of 81 liver transplantation (16 CDLT, 65 LDLT) were performed on 81 patients (56 male and 25 female) who had end stage liver at our hospital. The patients were split in two groups, as similar previous studies. High transfusion group (HTG) (g4 RBC) was compaired againts the low transfusion group (LTG) (l 4RBC). Univariate analysis was performed with the independent student's t- test for quantitative variables and chi-square test was used for qualitative variables after data categorization and calculation. RESULTS: The mean transfused units of red blood cell (RBC) was 5.41. Patient's age, availabity of HCV and elevated Child score had significance for intraoperative blood transfusion requirement. Postoperative mortality and reoperation rate had significantly elevated in HTG patients also HTG patients had more infectious. CONCLUSION: We concluded that high blood transfusion has major effect on posttransplant complications and postoperative mortality Key words: Liver transplantation, Blood transfusion, Postoperative outcomes
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